
[Greek gonorrhoia, flow of seed (from the mistaken belief that the discharge contained semen) : gono-, gono- + -rhoia, -rrhea.]
gonorrheal gon'or·rhe'al or gon'or·rhe'ic adj.For more information on gonorrhea, visit Britannica.com.
A common sexually transmitted disease caused by the bacterium Neisseria gonorrhoeae. Humans are the only natural hosts for N. gonorrhoeae, which directly infects the epithelium of the mucous membranes of the human genital tract, pharynx, rectum, or conjunctiva. Local epithelial cell destruction usually occurs, but the organisms may spread to adjacent organs or disseminate via the bloodstream. In women, local complications include inflammation of the uterine lining (endometritis), inflammation of the fallopian tube (salpingitis), inflammation of the abdominal wall (peritonitis), and inflammation of Bartholin's glands (bartholinitis); in men, periurethral abscess and inflammation of a duct connected to the testes (epididymitis). Systemic manifestations such as arthritis or dermatitis may develop, and rarely endocarditis or meningitis.
Women are disproportionately affected by the complications of gonorrhea. Acute pelvic inflammatory disease and salpingitis, the most serious complications of gonorrhea, result in ectopic pregnancy and infertility. Gonococcal infection during pregnancy may also predispose women to premature rupture of membranes, delivery in less than full term, and postpartum endometritis. During childbirth, the gonococcus may infect the conjunctiva of the infant and result in the infection ophthalmia neonatorum. This infection is a serious complication that remains common in less developed countries and can lead to permanent damage to the eye and blindness. See also Infertility; Reproductive system disorders.
Gonorrhea continues to be the most commonly reported communicable disease in the United States, although incidence has declined since 1984. Risk factors that may influence the probability of infection include number of sexual partners, lack of barrier contraceptives, and young age.
Gonorrhea is an infection spread by physical contact with the mucosal surfaces of an infected person, usually a sexual partner. The risk of infection depends on the anatomic site, the amount of substance containing bacteria, and the number of exposures. Variations in host susceptibility have not been well defined. In a small but significant proportion of infections, there are no symptoms. These individuals are important in the epidemiology of this disease because gonorrhea is usually spread by carriers who have no symptoms or have ignored symptoms.
Control of gonorrhea depends on early diagnosis, effective treatment, and identification of asymptomatic individuals. The last has been accomplished, in part, through screening programs. However, complete control has not been possible because of the emergence and spread of strains that are resistant to less-expensive antimicrobial treatments such as penicillin and tetracycline.
There is no evidence that infected individuals develop long-lasting immunity to reinfection, and vaccination is not available. Thus, the prevention of gonorrhea relies on behavior modification and risk reduction, use of appropriate screening and diagnostic tests, routine use of highly effective antibiotics, early identification and treatment of sexual partners of individuals with gonorrhea, and the appropriate use of barrier methods such as condoms.
An increasing proportion of infections are due to antibiotic-resistant strains of N. gonorrhoeae. Chromosomally mediated resistance to multiple antibiotics as well as plasmid-mediated resistance to beta-lactam antibiotics and tetracycline occurs in strains from both developed and developing countries. Nevertheless, infections can be effectively treated with third-generation cephalosporins (for example, ceftriaxone) or fluoroquinolones (for example, ciprofloxacin or ofloxacin). See also Sexually transmitted diseases.
Gonorrhea is a sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, a bacterium. Gonorrhea is spread through sexual contact (vaginal, oral, or anal). The organism can grow easily in mucous membranes of the body, including the cervix, uterus, and fallopian tubes in women, and the urethra, mouth, throat, and rectum in women and men. It can also invade the conjunctiva (e.g., during childbirth). Each year approximately 650,000 persons in the United States get gonorrhea. Approximately 75 percent of gonorrhea cases are found in persons age fifteen to twenty-nine years. About 50 percent of men have some initial symptoms, typically a burning sensation when urinating and a discharge from the penis. Many infected women are asymptomatic or have only mild symptoms. Initial symptoms include a painful or burning sensation when urinating and a vaginal discharge that is yellow or bloody. Untreated gonorrhea in women can develop into pelvic inflammatory disease (PID), which can cause infertility or increase the future risk of ectopic pregnancy. An infected pregnant woman can transmit the infection to her newborn during vaginal delivery.
N. gonorrhoeae in the male or female genital tract can be diagnosed in a laboratory using a urine specimen. Many of the currently used antibiotics can successfully cure gonorrhea. Persons who engage in sexual behaviors that place them at risk of STDs should use latex or polyurethane condoms every time they have sex, limit the number of sex partners, and not go back and forth between partners. All young, sexually active, nonmonogamous persons who do not use condoms every time they have sex should consider being screened for gonorrhea yearly. Infected persons should notify all sex partners so they can receive treatment.
(SEE ALSO: Sexually Transmitted Diseases)
Bibliography
Centers for Disease Control and Prevention (1998). "1998 Guidelines for Treatment of Sexually Transmitted Diseases." Morbidity and Mortality Weekly Report 47(RR-1):59–70.
Hook, E. W., III, and Handsfield, H. H. (1999). "Gonococcal Infections in the Adult." In Sexually Transmitted Diseases, 3rd edition, eds. K. Holmes, P. Mardh, P. Sparling et al. New York: McGraw-Hill.
— ALLISON L. GREENSPAN; JOEL R. GREENSPAN
The usual site of infection in women is the cervix. From there it can spread to the uterus and fallopian tubes and cause pelvic inflammatory disease, ectopic pregnancy, or infertility. Other complications, in both sexes, include infection of the joints, heart valves, and brain. Women are often asymptomatic, but may have a vaginal discharge or burning sensation on urination; men may have a discharge from the penis and pain on urination. Examination of the discharge reveals the presence of the bacteria. In most cases, the disease can be cured by adequate treatment with a cephalosporin antibiotic such as cefixime or ceftriaxone. Failure of treatment is usually due to resistant strains (see drug resistance); gonorrhea is now resistant to many antibiotics formerly used to cure it. Prior infection does not confer resistance and reinfection is common.
An acute and sexually transmitted disease, caused by bacteria that invade the mucous membranes of the genitals and urinary tract. In women, the disease can also spread to the cervix, fallopian tubes, and ovaries, leading to chronic pelvic pain or infertility. In both sexes, the disease can spread to the joints and skin (or, more rarely, the heart or brain) if left untreated. The disease can be treated with antibiotics.
A sexually transmitted disease of the genitourinary tract which is spread by direct contact with an infected person or fluids containing the infectious microorganism. The disease may also affect the conjunctiva, oral tissue, and other tissues and organ systems.

| Gonorrhea | |
|---|---|
| Classification and external resources | |
During WWII, the US government used posters to warn servicemen about the dangers of gonorrhea and other sexually transmitted infections. |
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| ICD-10 | A54 |
| ICD-9 | 098 |
| MedlinePlus | 007267 |
| eMedicine | article/782913 |
| MeSH | D006069 |
Gonorrhea (also colloquially known as the clap[1]) is a common human sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are burning with urination and penile discharge. Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain. In both men and women if gonorrhea is left untreated, it may spread locally causing epididymitis or pelvic inflammatory disease or throughout the body, affecting joints and heart valves.
Treatment is commonly with ceftriaxone as antibiotic resistance has developed to many previously used medications.
In 2011, there were reports of some strains of gonorrhea showing resistance to ceftriaxone.[2]
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Contents
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Half of women with gonorrhea are asymptomatic while others have vaginal discharge, lower abdominal pain or pain with intercourse.[3] The most common male symptoms are urethritis associated with burning with urination and discharge from the penis.[3] Either sex may also acquire gonorrhea of the throat from performing oral sex on an infected partner, usually a male partner. Such infection is asymptomatic in 90% of cases, and produces a sore throat in the remaining 10%.[4] The incubation period is 2 to 14 days with most of these symptoms occurring between 4–6 days after being infected.[5] Rarely, gonorrhea may cause skin lesions and joint infection (pain and swelling in the joints) after traveling through the blood stream (see below). Very rarely it may settle in the heart causing endocarditis or in the spinal column causing meningitis (both are more likely among individuals with suppressed immune systems, however).[4]
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae.[3] The infection is transmitted from one person to another through vaginal, oral, or anal sex.[3] Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. The risk for men who have sex with men is higher.[6] Women have a 60–80% risk of getting the infection from a single act of vaginal intercourse with an infected man.[7] A mother may transmit gonorrhea to her newborn during childbirth; when affecting the infant's eyes, it is referred to as ophthalmia neonatorum.[3] It cannot be spread by toilets or bathrooms.[8]
Traditionally, gonorrhea was diagnosed with gram stain and culture; however, newer polymerase chain reaction (PCR) based testing methods are becoming more common.[9] In those who fail initial treatment culture should be done to determine sensitivity to antibiotics.[10] All people who test positive for gonorrhea should be tested for other sexually transmitted diseases such as chlamydia, syphilis and human immunodeficiency virus.[10]
The United States Preventive Services Task Force recommends screening for gonorrhea in women at increased risk of infection which includes all sexually active women younger than 25 years. It is not recommended in males without symptoms or low risk women.[11]
While the only sure way of preventing gonorrhea is abstaining from sexual intercourse, the risk of infection can be reduced significantly by using condoms correctly and by having a mutually monogamous relationship with an uninfected person.[12][13]
Gonorrhea if left untreated may last for weeks or months with higher risks of complications.[3] As of 2010 injectable ceftriaxone appears to be one of the few effective antibiotics.[10] Because of increasing rates of antibiotic resistance local susceptibility patterns need to be taken into account when deciding on treatment.[10] Many antibiotics that were once effective including penicillin, tetracycline and fluoroquinolones are no longer recommended because of high rates of resistance.[10] Cases of resistance to ceftriaxone have been reported but are still rare.[10][10]
As of 2011[update], there are reports of strains of gonorrhea that show antibiotic resistance to multiple agents, specifically to both cefixime and ceftriaxone.[14][15][16][2]
In a 2012 news story, ABC News reported, "A new editorial published in the New England Journal of Medicine highlighted the concern for the rising rate of antibiotic-resistant gonorrhea in the U.S. While the prevalence of resistance to the drug was about .1 percent in 2006, that number jumped to 1.7 percent by mid-2011, the editorial noted."[17]
It is recommended that sexual partners be tested and potentially treated.[10] One option for treating sexual partners of people infected is patient-delivered partner therapy (PDPT) which involves providing prescriptions or medications to the person to take to their partner without the health care provider first examining them.[18]
One of the complication of gonorrhea is systemic dissemination resulting in skin pustules or petechia, septic arthritis, meningitis or endocarditis.[3] This occurs in between 0.6 and 3.0% of women and 0.4 and 0.7% of men.[3]
In men, inflammation of the epididymis (epididymitis); prostate gland (prostatitis) and urethral stricture (urethritis) can result from untreated gonorrhea.[20] In women, the most common result of untreated gonorrhea is pelvic inflammatory disease. Other complications include perihepatitis,[20] a rare complication associated with Fitz-Hugh-Curtis syndrome; septic arthritis in the fingers, wrists, toes, and ankles; septic abortion; chorioamnionitis during pregnancy; neonatal or adult blindness from conjunctivitis; and infertility.
Neonates coming through the birth canal are given erythromycin ointment in the eyes to prevent blindness from infection. The underlying gonorrhea should be treated; if this is done then usually a good prognosis will follow.
Among persons in the United States between 14 and 39 years of age, 46% of people with gonorrheal infection also have chlamydial infection.[21]
Gonorrhea is a common infectious disease. WHO estimates that 62 million cases of gonorrhea appear each year.[22]
In the United Kingdom 196 per 100,000 males 20 to 24 years old, and 133 per 100,000 females 16 to 19 years old were diagnosed in 2005.[3] The CDC estimates that more than 700,000 people in the United States get new gonorrheal infections each year. Only about half of these infections are reported to CDC. In 2004, 330,132 cases of gonorrhea were reported to the CDC. After the implementation of a national gonorrhea control program in the mid-1970s, the national gonorrhea rate declined from 1975 to 1997. After a small increase in 1998, the gonorrhea rate has decreased slightly since 1999. In 2004, the rate of reported gonorrheal infections was 113.5 per 100,000 persons.[23]
In the US, it is the second most common bacterial sexually transmitted infections after chlamydia.[24][25] According to the CDC, "Overall, African Americans are most affected by gonorrhea. Blacks accounted for 69% of all gonorrhea cases in 2010."[26]
It has been suggested that mercury was used as a treatment for gonorrhea. Surgeons' tools on board the recovered English warship the Mary Rose included a syringe that, according to some, was used to inject the mercury via the urinary meatus into any unfortunate crewman suffering from gonorrhea. The name "the clap", in reference to the disease, is recorded as early as the sixteenth century.[1]
Silver nitrate was one of the widely used drugs in the 19th century, but it became replaced by Protargol. Arthur Eichengrün invented this type of colloidal silver, which was marketed by Bayer from 1897 on. The silver-based treatment was used until the first antibiotics came into use in the 1940s.[27][28]
The exact time of onset of gonorrhea as prevalent disease or epidemic cannot be accurately determined from the historical record. One of the first reliable notations occur in the Acts of the (English) Parliament. In 1161 this body passed a law to reduce the spread of "...the perilous infirmity of burning."[29] The symptoms described are consistent with, but not diagnostic of, gonorrhea. A similar decree was passed by Louis IX in France in 1256, replacing regulation with banishment.[30] Similar symptoms were noted at the siege of Acre[disambiguation needed
] by Crusaders.
Coincidental to, or dependent on, the appearance of a gonorrhea epidemic, several changes occurred in European medieval society. Cities hired public health doctors to treat afflicted patients without right of refusal. Pope Boniface[disambiguation needed
] rescinded the requirement that physicians complete studies for the lower orders of the Catholic priesthood.[citation needed]
Medieval public health physicians in the employ of their cities were required to treat prostitutes infected with the "burning", as well as lepers and other epidemic victims.[31] After Pope Boniface completely secularized the practice of medicine, physicians were more willing to treat a sexually transmitted disease.[citation needed]
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Français (French)
n. - blennorragie
Deutsch (German)
n. - Gonorrhöe, Tripper
Ελληνική (Greek)
n. - γονόρροια, βλενόρροια
Português (Portuguese)
n. - gonorréia (f) (Med.)
Español (Spanish)
n. - gonorrea
Svenska (Swedish)
n. - gonorré
中文(简体)(Chinese (Simplified))
淋病
中文(繁體)(Chinese (Traditional))
n. - 淋病
العربيه (Arabic)
(الاسم) مرض جنسي, السيلان
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